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May 2010, Volume 40 Number 5 , p 62 - 63


  • Diane Deitz MSN, ACNP, CWON, CWS
  • Judy Gates MSN, RN-BC, CWS, FAACCWS


OUR PREVIOUS ARTICLE focused on colostomy types and immediate postoperative concerns. This article describes pouching systems, skin care, and dealing with complications.Most ostomy pouching systems are lightweight, odor-proof, and relatively low maintenance.1,2 Choosing the most appropriate system for your patient may involve some trial and error.When choosing a pouching system, consider the size and shape of the stoma, anatomic location of the stoma, location of the stomal lumen, level of stomal protrusion, abdominal contour, type of drainage, and patient preference. You may need to cut or mold the skin barrier (the adhesive disk placed on the skin around the stoma) to accommodate the size and shape of the stoma. Leave no more than 1/8 inch of skin showing around the stoma. Skin barriers can be flat (recommended when the stoma protrudes at least 1 inch [2.5 cm] from the abdomen) or convex. The curved surface of the convex skin barrier puts gentle pressure on the skin around the stoma,

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